Abstract

Pluralism and creativity are inherent and important parts of the qualitative endeavour. The

multiplicity of approaches and methods can, however, be confusing. We undertook a focused

mapping review and synthesis to obtain a snap-shot profile of the state of qualitative research

in health and social science literature. We retrieved 102 qualitative articles published between

January and March 2015 from six leading health and social science journals. Articles were

scrutinised for alignment between researchers’ reported orientation (methodological or

philosophical positioning) and the techniques used (methods). In the sampled articles level of

alignment was generally high, with considerable mastery of qualitative approaches evident.

However, the complexity of the qualitative landscape highlighted in our review, led us to

develop a diagrammatic representation: The Qualitative Research Level of Alignment

Wheel™. This educational resource/teaching aid is designed to assist qualitative researchers

(particularly those more novice) and research students to locate the orientation and techniques

of their studies. As an important contribution to the international field of qualitative inquiry, it

will assist in understanding and accounting for points at which techniques are melded and

orientations blended. In turn this will lead to the individual and collective qualitative

endeavour as being a coherent one.

Key words

Alignment, mapping, method, novice, orientation, qualitative, quality, reporting, review,

teaching, technique

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The State of Qualitative Research in Health and Social Science Literature: A Focused

Mapping Review and Synthesis

Introduction

Qualitative research provides a fundamental contribution to social inquiry that seeks to

understand the meaning of human actions (Schwandt, 2001). Like human actions themselves,

the modes of understanding them are multiple and varied. Pluralism and creativity are

important and inherent parts of the qualitative endeavour and there are many methodological

approaches, each with a different contribution to make. Hammersley (2008) observed that

rather than a set of clearly differentiated qualitative approaches, there is a complex landscape

of variable practice with an associated range of descriptors, such as ‘ethnography’, ‘discourse

analysis’, ‘life history’, ‘interpretivism’ or ‘feminist epistemology’. Such variety is congruent

with the multiplicity of human actions and multiple ways that human beings interpret the

world, that attract qualitative investigation.

Several years ago Creswell (2007) presented a helpful analysis of what he discerned

as the five traditions of qualitative inquiry: biography, phenomenology, grounded theory,

ethnography and case study. He described the key elements of each, mapped to a six-stage

research process. By traditions of inquiry he meant:

An approach to qualitative research that has a distinguished history in one of

the disciplines and has spawned books, journals, and distinct methodologies

(Creswell, 2007: 2)

[Insert Table 1]

Latterly, Creswell changed ‘biography’ to ‘narrative’ and the ‘traditions’ have become

‘approaches’ (Creswell, 2013). Like Hammersley, he acknowledged rich variation within

qualitative research with respect to the five different approaches. But he showed how each

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approach has a unique purpose, with its own particular structural and practical characteristics

(these are outlined in Table 1). Grounded theory, for example, consists of at least three

different versions, each with their own unique and often conflicting views on the purpose and

processes of doing grounded theory research (Breckenridge et al., 2012). Phenomenology has

several methodological strands, each with a different focus and structure, for example,

descriptive, interpretive, hermeneutic or lifeworld phenomenology (Finlay, 2012). Narrative

inquiry can adopt many different analytic lenses, drawn from a variety of social and

humanities disciplines, and case study methodology can vary in scope from intrinsic, single

case to collective or comparative cases (Creswell, 2013). Likewise, there are different types

of ethnographic study, including traditional, structural, post-modern reflexive, feminist,

institutional, and auto-ethnographic approaches (Van Manaan, 1988; Davies, 1999; Ellis,

2004; Sharma, Reimer-Kirkham & Cochrane, 2009; Taber 2010). Indeed, Mannay and

Morgan (2015) argue that most qualitative research is in fact an ethnographic undertaking.

Diversity of approaches available to qualitative researchers is not problematic per se

and actually it is a significant benefit. It provides a rich pool of methodological and technical

options that researchers can use to, for example, expound and explain human reasoning;

advocate for participants’ experience; examine the contexts in which services operate;

develop new theory; and offer insight into the inner-workings of effective, or ineffective,

interventions (Greenhalgh et al., 2016). As Madill and Gough (2008) argue, qualitative

research is a diverse field and many researchers are actively seeking links across qualitative

approaches.

However, while versatility and plurality are aspects of qualitative research that we

embrace in our own work, the multiplicity of approaches and methods can be confusing. It

may also account for the inconsistency with which qualitative research is sometimes

conducted and reported. Certainly, qualitative research has been subject to much scrutiny and

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critique, from which none of the five approaches are immune. For instance, there has been

long-standing criticism of the lack of philosophical understanding and consistency among

many researchers claiming to use phenomenology (Cohen & Omery, 1994; McNamara, 2005;

Thomas, 2005; Porter, 2008; Earle, 2010; Norlyk & Harder, 2010). Grounded theory is still a

highly popular methodology, however this tends only to extend to the use of one or two

methodological components in isolation, using constant comparison as a method for data

analysis, rather than adopting the methodology as a ‘full package’ (Cutcliffe, 2005;

Greckhamer & Koro‐Ljungberg, 2005; Holton, 2007). Ethnographic studies are similarly

critiqued with respect to varying levels of ‘participant observation’ in the field (Ellen, 1984;

Emerson et al., 1995; Manias & Street, 2001; Pope, 2005). So what is it that accounts for

such criticisms across the range of qualitative approaches?

Creswell (2013) suggests that researchers may be hampered by insufficient

understanding of the chief elements of each methodological approach, thereby resulting in a

confused, diluted and inconsistent product. Sometimes there is disconnect between the

qualitative approaches that researchers claim to use, and the respective methods and

techniques they actually employ. Drawing on the work of Kaplan (1964), Sandelowski and

Barroso (2007) have characterised this disconnect as the difference between ‘reconstructed

logic’ (what authors say they do) and ‘logic-in-use’ (what authors actually do in their studies).

In our article, we report on a focused mapping review and synthesis that examined the

extent to which there is congruence between authors’ stated qualitative orientation

(reconstructed logic) and the research processes and techniques actually reported (logic-in-

use). The article arises from our academic curiosity as qualitative researchers regarding the

‘current state of play’ within our own disciplines of health and social sciences. As far as we

are aware, there have been no previous attempts to review and synthesise the literature in this

way, in any discipline. Of those that have undertaken similar areas of inquiry, Riessman and

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Quinney (2005) reviewed the use of narrative research in social work journals over a period

of 15 years (1990-2005). They found that the majority of 200 plus papers reviewed, whilst

claiming in their titles to use ‘narrative’ methods, had in fact used methods such as thematic

or content analysis that are non-conducive to a true narrative approach. The review by

Riessman and Quinney (2005) is a good indication that there are likely to be similar problems

with other methodologies, and we felt a wider analysis of multiple qualitative methodologies

was merited. Guetterman (2015) recently analysed sampling practices across the five

approaches in education and health sciences, finding inconsistent approaches being used.

Guetterman’s analysis, however, focused solely on sampling. Richards et al. (2014) found

methodological inconsistencies and concerns about reporting in qualitative studies as part of

their analysis of 223 articles in nursing. Their focus however was limited by disciplinary

scope (nursing only). Caelli and colleagues (2003) and Madill and Gough (2008) have

provided critiques of qualitative research but in the form of discussion papers with examples,

rather than systematic analyses.

Our article therefore, makes a meaningful and contemporary contribution to

qualitative research in health and social sciences. Importantly, our findings have led to a

useful teaching resource that we discuss later.

Our approach

The aim was to profile the relationship between qualitative researchers’ philosophical

claims and their actual methodological practices in the context of reporting in health and

social science journals. In relation to researchers’ reporting of qualitative research, the review

questions were:

1. What claims are made regarding philosophical positioning? (Orientation)

2. What study designs and data generation methods are used? (Technique)

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3. What types of analytical approaches are used? (Technique)

4. What is the degree of alignment between methodological orientation and respective

techniques within individual articles? (Patterning)

5. What patterns can be discerned across articles and journals? (Patterning)

Four of the authors (insert initials) have been part of research teams that have developed a

method we describe as a ‘focused mapping review and synthesis’. This is a development and

extension of the mapping review and synthesis described by Grant and Booth (2009) in their

typology of 14 review types. It is focused in three ways: 1) particular subject; 2) a defined

time period; 3) specific journals. Unlike some other forms of review such as systematic

reviews that strive towards breadth and exhaustive searches, the focused mapping review

searches within specific, pre-determined journals. Platt (2016) observed that 'a number of

studies have used samples of journal articles' (p. 31) but the distinctive feature of the focused

mapping review and synthesis is the purposive selection of journals. These are selected on the

basis of their likelihood to contain articles relevant to the field of inquiry – in this case

qualitative research published in a range of journals from the health and social sciences.

We undertook a focused mapping of empirical, qualitative research articles published

during the first quarter of 2015 in six different journals: British Journal of Social Work

(BJSW); Health and Social Care in the Community (HSCC), Journal of Advanced Nursing

(JAN), Qualitative Health Research (QHR), Social Science and Medicine (SS&M) and

Sociology of Health and Illness (SH&I). We selected these particular journals because of

their likelihood to publish qualitative articles. We included an equal number of profession and

context specific journals (BJSW; HSCC; JAN) and methodology focused journals (QHR;

SS&M; SH&I) in order to capture qualitative papers written for different audiences. As a

multi-disciplinary team of nurses, health visitors and occupational therapists, we identified

these six journals as being most prominent in health and social care and as being well known

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in our respective professions. Journals were excluded if they published methodological

papers rather than findings from primary studies (such as International Journal of Social

Research Methodology).

[Insert Table 2]

Table 2 shows the inclusion and exclusion criteria for the review. We included all articles that

reported on primary empirical, qualitative research, published in the three month period

between January 1st and March 31st 2015. We excluded systematic reviews, methodological

and theoretical reports and mixed method studies. Each team member was responsible for

searching within one of the selected journals for retrieval of articles.

[Insert Table 3]

Every article published in the timeframe was scrutinised against the inclusion and ex-

clusion criteria. Articles meeting the inclusion criteria were read in full and the lead reviewer

for each journal loaded predefined details onto a proforma developed for the project (Table

3). We ranked each article as having high, partial or low levels of alignment. As indicated in

Table 3, the descriptor for assessing level of alignment was the degree of congruence and fit

between researchers’ orientation (the underlying world view/philosophical stance) and re-

search technique. In this we asked ourselves ‘Do authors do what they say? Are there any

surprises in what they do? Have researchers used congruent techniques associated with their

claimed approach (phenomenology, grounded theory etcetera)?’ This was necessarily a sub-

jective process and we accept that our judgements will have been influenced by what Sande-

lowski calls a ‘matter of taste’.

‘Taste refers to the ability to be discriminating about some object of

evaluation. Individuals are considered to have good taste to the extent that they

show a cultivated or educated eye, ear or feeling for an object among other

objects of its kind’ (Sandelowski, 2015: 87).

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Our own cultivation and education is based on considerable, collective years in the field as

qualitative researchers and our professional intuiting regarding quality in qualitative research.

However, in an attempt to instil rigour in the process, the appraisal of every article was veri-

fied by a second reviewer within the team: we worked in pairs.

Using Table 1 as a framework, we mapped the orientation as stated in each article to the five

approaches as described by Creswell. Some authors reported a combined orientation that

straddled research approaches, and in such cases the primary or dominant approach was re-

corded. Our classifications were cross-checked by a second reviewer within our pairs. In

cases of ambiguity or uncertainty (of which there was a great deal), discussion within the

wider group resolved such issues and on-going refinements to the criteria were made in the

early stages. We also held two calibration exercises with the entire review team, where on

each occasion the classification and proforma results of randomly selected articles were dis-

cussed at length. The aim of the calibration was to ensure that we were all working within the

same parameters of understanding. The calibration meetings provided a mechanism to ex-

plain our judgements, discuss the subtleties of the evaluation/judgement process and create

consensus regarding classifications. We retrieved 106 articles that were considered to meet

our inclusion criteria, but four were excluded because they reported on mixed methods stud-

ies. This resulted in 102 articles being included in our review (Table 4).

What we found from the review

Orientation

In the first instance we scrutinised titles looking for an explicit statement regarding

use of a qualitative approach. Where these were clearly and explicitly stated we classified

them as ‘Yes’. There are certain conventions among qualitative researchers in formulating

titles by use of: 1) participant quotes, 2) metaphor and 3) posing a title as a question. So we

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searched titles for what we termed ‘implied’ use of qualitative research, hallmarked by any of

these three conventions. We also looked for other markers of qualitative studies by

identifying the language and methods often associated with qualitative approaches, for

example, ‘lived experience’, focus groups and interviews. Table 4 shows the findings from

this part of our analysis. Of the 102 articles only 17 (16.6%) met the ‘Yes’ criteria for having

stated in the title that a qualitative approach had been used. A further 39 (38.2%) were

‘Implied’ and a majority of 46 articles (45%) were categorised as ‘No’. These did not state or

explain their qualitative approach in the title of their article (the statement was made

somewhere in the abstract, key words and/or body of the article). Overall, SS&M ranked high

in this part of the analysis, with 15 out of the 19 included articles having explicit or implied

statements about the approach in the title. Table 5 provides an overview of selected criteria

including title or maximum wordage relevant for the reporting of original (qualitative)

research as depicted in the author guidelines of the respective journals.

[Insert Table 4]

[Insert Table 5]

Orientation across Journals

As shown on Table 5, the approaches as described by Creswell (2013) were reported

to be used 46 (45%) times. Of the five approaches, ethnography proved most popular (15.7%)

and was most commonly reported in SH&I and SS&M. This was followed by

phenomenology (9.8%) which was most strongly represented in QHR. Grounded theory

(6.9%) and case study (6.9%) appeared more or less equally represented across journals.

Narrative approaches were least represented overall (5.9%) and most of these were published

in QHR.

[Insert Table 6]

Aside from identifying articles whose qualitative orientation mapped to one of

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Creswell’s (2013) approaches, we identified 43 (42.1%) articles that we classified as using

‘generic qualitative’ approaches. An array of descriptors was used by researchers in such

articles, including, qualitative study; descriptive exploratory study; qualitative descriptive

study, qualitative approach underpinned by interpretivism; inductive qualitative approach.

The category determined as ‘Other’ included 13 (12.7%) approaches that were difficult to

subsume within any of the previously discussed categories, for example, co-operative

enquiry, biopedagogy, realist evaluation and participatory mapping. Although less than half of

the qualitative articles included in our review applied Creswell’s five approaches, this does

not allow conclusions to be drawn regarding the quality of the research undertaken. Indeed

much of such generic qualitative research ‘borrows’ methodological components that have

origins within Creswell’s five approaches anyway.

[Insert Figure 1]

Data Generation Techniques

We present this as a figure rather than a table, to show that data generation and analysis in

qualitative research are most often overlapping and are not discrete processes. Representing

them in this way avoids seeing them as separate activities. As shown in Figure 1, individual

interviews were the most popular form of data generation by far, with 87 researchers

reporting the use of this method. Observation and focus group were reported in 14 and 13

articles respectively. Observations were most commonly reported in SH&I (10) and of these

there were also four uses of field notes with participant observation. There was an array of

other techniques (13) including vignettes, emails, photographs and drawings.

Data Analysis Techniques

Thematic analysis was popular with 31 articles describing this approach, within this

the approach of Braun and Clark (2006) was cited frequently. Use of framework analysis

following Ritchie and Spencer (1994) or Ritchie and Lewis (2003), was reported in nine

10

articles. Interestingly, 30 articles reported the use of open coding, axial coding, constant

comparison and memoing. These are terms usually associated with grounded theory and

given that only seven articles reported the use of grounded theory this was an interesting

finding. Other data analysis techniques (n=10) included qualitative data analysis, deductive

analysis, and visual mapping technique. Thirty six articles reported the use of computer

software for analysis, most often NVivo.

Patterning of Alignment and Orientation

[Insert Table 7]

This part of the analysis was concerned with the degree of alignment between

methodological orientation and respective techniques across the different qualitative

approaches. As shown in Table 7, levels of alignment were high (n=65) with many

researchers demonstrating sophisticated engagement with qualitative approaches and well-

described orientations and techniques (see for example the phenomenologically inspired

narrative approach of Caddick et al., 2015, that incorporates the techniques of interviews and

participant observation). Early in their paper, these authors refer to key theorists and

philosophers from whom they draw inspiration, namely, Frank and Merleau-Ponty. Their

influence on the study is explained and critiqued and they are referred to throughout; through

to the discussion and conclusion. Data collection and analysis are explained in relation to

both the narrative and phenomenological orientation and the data presented have a narrative

‘feel’. The reporting of Caddick and colleagues’ complex blending of orientations and

techniques has potential to be confused. It is in fact an example of clarity and cohesiveness,

with high level of alignment.

The mapping found only a minority of articles (n=4) showing a mismatch of

alignment between orientation and technique. This is a positive finding with respect to the

field of qualitative research in health and social science literature. When considering

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patterning across approaches it is noteworthy that high levels of alignment are associated

with generic qualitative approaches, with 32 out of the 43 articles within this category

achieving high levels of alignment. This may seem surprising given the variety and

heterogeneity of this group of articles. What it shows however, is that where level of

alignment is concerned, it is ‘safer’ to describe research as generic, than to claim alignment to

a specific approach and for this to be poorly aligned and poorly described. It also underscores

the importance of understanding an orientation when claims are made for its influence on a

study.

Limitations of our approach

This focused mapping review and synthesis aimed to shed light on a particular topic

that has hitherto been un-investigated. Whilst other types of review were possible, a focused

mapping review and synthesis was chosen. This has inherent limitation regarding scope. The

snap-shot is contextual and temporal and it could be argued that findings from this form of

review are an artefact of the included journals: another timeframe with other journals would

likely create a different profile. However, as an impression of the state of qualitative research

in health and social science literature, our review has provided useful insights. Similarly,

findings are based on a small sample of good quality social science, health, nursing and social

work/care journals and it is difficult to generalise to the very large number of journals that

publish qualitative research. A larger range of journals from across more disciplines beyond

health and social sciences may reflect greater diversity in how qualitative research is

currently reported. This is a suggestion for further reviews. That said, in her analysis of what

makes good qualitative research, Meyrick (2006) examined how quality judgements vary

across different disciplines. For example, bio-medical approaches and sociology focus on

objectivity, researcher neutrality and distance from data; in psychology/ health psychology,

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transparency, reflexivity and practical utility are important; and health services research tends

to value ontological differences and generation of theory. Therefore, attempting to analyse

across too many disciplines may prove problematic.

During the mapping of orientations, we used Creswell’s five approaches as the

framework and our project may be limited by focusing too narrowly on one scholar’s work.

We chose Creswell’s five approaches because in our experience they are well-recognised and

helpful to many novice qualitative researchers. Also, although there is some over-lap, they

provide detailed descriptions of techniques for each approach.

We may also be criticised for failing to provide details of every article included in our

review. However, there were 102 and this would have been unwieldly. We have provided

details of exemplar articles in relation to each of the three levels of alignment to assist readers

in understanding our analysis and findings. Our review has included judgements about other

qualitative researchers’ work and some may regard this as threatening or critical. But our

intention has been to explore the current state of play and we have highlighted the strength of

qualitative research (although there are some areas for improvement).

Finally, reflecting on the words of Tight (2016, p. 320) ‘Research design typically

encompasses methodological and theoretical positions or viewpoints (even if these are not

recognised and articulated)’. We found apparent uncritical blurring and confusion among

some researchers regarding orientation and technique and we advocate the need for greater

clarity in the recognition and articulation of philosophical stance, methodology, theory and

methods in qualitative research, and the relationships between them.

Mannay and Morgan (2015) have argued that qualitative researchers have become

distracted by technique and arguably this criticism could be levied at us. But we are not

advocating staunch methodological purism. One of the joys of qualitative research is its

flexibility and this allows considerable deviation and adaptation of design (Grbich, 2007;

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Madill & Gough 2008). Qualitative approaches are diverse, complex and nuanced (Braun &

Clarke, 2006) and this is to be embraced. We agree with Frost and colleagues (2010) and

Taber (2010), that pluralism in qualitative research is not only possible, but also desirable.

Methodological elements can be combined and novel approaches can be taken in order to

advance and improve existing methodological approaches. We do not dissuade such

hybridisation. Rather, we argue that it needs to occur knowingly and purposefully and be

rooted in a sound understanding and reporting of the compatibility of different philosophical

underpinnings and practical applications.

Reflections on our review

The discussion is based upon a number of issues stemming from the outcomes of our

review (the findings) and our experiences of undertaking it (the processes).

Is this article qualitative - or not?

The starting point for our analysis was to make decisions about whether an article was

‘qualitative’ as judged by the title. This proved more of a challenge than we had anticipated

and the majority of article titles did not make this clear. A considerable majority gave no hint

in neither the abstract nor the key words. As indicated in Table 5, publishing conventions and

the role of journal editorial policies will undoubtedly influence this (along with structure,

content, and framing the way that methods are presented). Also, in the case of some journals,

for example QHR, the focus of the journal on qualitative research explains this. Why would it

be necessary given the qualitative focus of the journal? In QHR, advice is given to ensure that

titles are descriptive, unambiguous and accurate but there is no explicit recommendation to

include the methodology in the title. But, might there still be scope for authors to include

details of their specific qualitative orientation in order for readers to get a fuller picture of the

article? For journals who publish articles with methodological variety, this issue is all the

more important. There might be many reasons why a reader needs to know whether or not an

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article is qualitative, in the case of those undertaking a meta-synthesis for example. Absence

or implied orientation makes retrieval difficult. Authors and journals have a vested interest in

making articles easy to find and we argue that in some cases qualitative researchers make this

difficult. In discussing our findings with colleagues, we have been asked on two occasions

whether qualitative researchers may be hiding their qualitative work and deliberately masking

it through use of ambiguous titles or avoidance of naming it as ‘qualitative’. The inference is

that they might somehow be fearful that it is not scientific enough in relation to other research

approaches. As researchers who are passionate about the qualitative endeavour we would be

disappointed if this was the case, but it is a point of reflection and further debate. In

conclusion, we would urge authors to seriously consider stating the methodology as one of

the main key phrase required in formulating a good title.

A repeated point of discussion among the research team during the process of our

review was ‘what makes a qualitative article qualitative?’ We came across a number of

articles (for example, Chang & Basnyat, 2015; Fisher, 2015; Rees et al., 2015) that created a

great deal of debate regarding their use of numbers/statistics. Maxwell (2010) observed that

the use of numerical data in qualitative research is controversial. It certainly challenged us to

reflect on our own understandings. In this we remained grounded in what authors told us

about their articles. Our argument is that numbers are not antithetical to qualitative inquiry.

They have a legitimate and valuable place for qualitative researchers when used as a

complement to the process (Maxwell, 2010). Similarly, Hesse-Biber’s work on qualitatively-

driven mixed methods research (Hesse-Biber, 2010; Hesse-Biber, Rodriguez & Frost, 2015)

provides good explanation of how numbers can be used as a complement to the research

process. In our view, it is the orientation that is important and more so the clear articulation of

that orientation. It is noteworthy that the four articles cited as exemplars here were all ranked

as having high level of alignment. We think this demonstrates how the division between

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quantitative and qualitative approaches can be arbitrary, and dichotomising them is unhelpful.

Orientation and techniques

The most frequently used technique in the included articles was the qualitative interview.

Savage and Burrows (2007) have made some interesting points about interviews, arguing that

sociology faces ‘a coming crisis’ regarding their use. They suggest that while in-depth

interviews were deployed in innovative ways in the 1970s their significance is now less clear.

As a tool to generating sophisticated understandings of diverse populations in contemporary

society, they propose that the place of the in-depth interview is uncertain, because:

‘The world-views of diverse populations (are) now routinely presented to us in the

popular and new media in such a manner that their summary characterization by

sociologists is no longer as necessary (or as interesting) as once it was’ (p.894).

We see this as a point of interest rather than concern and as already discussed, our review also

included reports of ‘newer’ approaches being used such as emails. As new technologies

emerge, the spectrum of techniques will increase, which eventually may indeed bring about

the demise of the in-depth interview.

An important part of our review was to rank articles for the level of alignment

between orientation and techniques. Most articles we reviewed had high level of alignment

(n=65), with examples of sophisticated engagement with qualitative approaches. This is not

to say that scientifically they were necessarily stronger than other articles in the review; we

did not review them for quality in this sense. Similarly, high level of alignment says nothing

about theoretical strength; this requires an altogether different judgement (Author 2 2014

details withheld for peer review). Arguably however, level of alignment is an important

indicator of rigour. A minority of articles (n=4) were deemed to have low level of alignment.

For example, we could not ‘see’ the grounded theory in the article by Riera et al. (2015) and

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we found the blending of phenomenology and ethnography in Mogensen and Mason’s (2015)

article confusing. We are not judging the science of these studies and they may be valuable

and of good quality in terms of their significance to knowledge development. However, as

readers, the alignment between what we expect to see in the published article and what we

get appear at odds.

Of the articles ranked as partial (n=33), many featured some degree of mismatch

between orientation and technique. Most often this was the unexplained application of

techniques associated with another orientation. For example, Kelly et al. (2015) unexpectedly

refer to Strauss and Corbin (1998) in their ethnographically orientated study. Similarly,

Liamputtong and Suwankhong (2015) report on the open coding and axial coding undertaken

as part of a thematic analysis (where they cite Braun and Clarke, 2006). Braun and Clarke

(2006) however, make it clear that thematic analysis differs from other analytic methods that

seek to describe patterns (such as those in phenomenology and grounded theory). While we

are not to judge whether authors are right or wrong in what they describe, we can observe that

as readers this is often confusing. We are not the first to make this point. Walting and

Linigard (2012) observed that grounded theory has been used as an umbrella term for a wide

variety of styles and approaches to qualitative data analysis. But they cautioned that the

anything goes approach is harmful to the credibility and relevance of grounded theory.

Richards and colleagues (2014) found that many researchers used words such as ‘thematic

analysis’, rather than providing details of the explicit philosophical assumptions guiding their

work. Likewise, Burnard (2004) advised that care should be taken with terms such as ‘content

analysis’ because the term is so broad as to have limited meaning. It could be argued that

content analysis is inherent in all qualitative data analysis and that coding and memoing are

components of many analytic approaches. What this calls for then, is the adoption of a critical

stance in relation to the techniques adopted and how these relate to the orientation.

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Importantly, it also calls for honesty and clarity in reporting.

Reporting Qualitative Research: Some Issues

Sandelowski and Barroso (2007) observed that ‘form is inescapably content’ (p.76) or

in other words, the article template or author guidelines will necessarily influence content.

We acknowledge that requirements imposed by journals do impact on publishing content and

style. For many qualitative researchers this can limit and stifle opportunities for creativity in

reporting. Arguably however, some aspects of guidance are needed for the sake of good

science. All of the journals included in our review make it clear in the author guidelines that

authors provide justification and rationale for their studies. Other guidance echoes this. For

example, the Critical Appraisal Skills Programme (2013) asks readers and reviewers to

consider whether the researcher has justified the research design. The Consolidated Criteria

for Reporting Qualitative Research (COREQ) (Tong et al., 2007: 351) developed to guide the

‘explicit and comprehensive reporting of qualitative studies’ includes among its 32 criteria,

the need to state the methodological orientation underpinning a study. Overall, the main goal

of reporting guidelines is to improve the clarity, completeness and transparency of research

reports (Simera et al., 2010). There are critics of checklists in qualitative research (Barbour,

2001) and potential stifling of the qualitative endeavour (Sandelowski, 1993). Kitto and

colleagues (2008) observed that the sheer number of checklists is overwhelming. They argued

however, that it is possible to develop clear and useful generic guidelines for assessing and

presenting qualitative research. In this we agree and findings from the review suggest the

need for improved reporting in some areas.

Author 1 (2009 withheld for peer review) observed that some qualitative researchers

align themselves with specific orientations (such as phenomenology or grounded theory)

inappropriately without understanding the implications of adopting this orientation. They

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argued that there are examples of studies that are mislabelled as phenomenological and would

be more appropriately referred to as generic research. Caelli et al. (2003) have a great deal to

say about the issue of generic research. They discern four basic requirements for such studies:

noting the researchers’ position; distinguishing method and methodology; making explicit the

approach to rigour; identifying the researchers’ analytic lens. In our review, level of

alignment was highest among articles with a ‘generic’ qualitative orientation, such as those of

Druetz and colleagues (2015) and van Hoof et al. (2015). Both of these articles are described

as ‘a qualitative study’ in the title. Neither of them is aligned to a particular orientation and in

both cases, the articles report quite ‘simply’ on the findings arising from the semi-structured

interviews they employ. Unlike Caddick and colleagues’ complex blending of orientation and

technique discussed earlier, these illustrative examples of high level of alignment are

characterised by simplicity. There are no surprises and you get what you expect in the

reporting. A message arising from the review therefore is to avoid claims to a specific

orientation unless it is articulated and visible within the reporting and when aligning to a

particular approach, to make sure it is understood. As Grbich (2007) cautions, if you choose a

particular path you need to understand and be able to articulate the epistemological and

ontology of that choice and how this might influence data collection and analysis.

[Insert Figure 2]

Development of a new resource for qualitative researchers

We focused considerable attention in the review on the five approaches as described

by Creswell. Regarding synthesis, we sought ways to work with the five approaches and

incorporate the generic orientations that were so dominant within the findings. In considering

influence on research practice, we debated how our findings might be of practical use among

those engaging with qualitative approaches, particularly those with less experience. We

envisioned a way of representing the findings diagrammatically, showing the linkages

19

between orientations and techniques. As a result, we developed the Qualitative Research

Level of Alignment Wheel™ (QR-LAW) (Figure 2). As a diagrammatic representation, it

shows the six dominant research orientations and their respective techniques, encompassing

Creswell’s five approaches and the sixth ‘generic qualitative’ domain. This captures the

breadth and variations in qualitative approaches reflected in our review.

As an educational and reflexive resource, the QR-LAW has potential to assist

predominantly novice qualitative researchers – and those more experienced – in locating the

orientation and techniques of their studies, and for them to be aware of, and account for,

points at which they might meld techniques or blend the different orientations. It may also

help researchers to articulate any ‘deviancy’ from considered norms within each approach by

better identifying the norms in the first instance. We have already begun to use the QR-LAW

with students undertaking post-graduate qualitative research classes. They have commented

favourably on its pedagogical benefits.

Our review has shown that some researchers competently blend approaches and in

doing so, push and advance the boundaries of qualitative research. The QR-LAW might assist

such researchers in justifying the changes to alignment they make with respect to drawing

from different perspectives. Researchers can conceptually turn the wheel through different

rotations and it will allow them to see where certain techniques may be ‘borrowed from’

regarding the six orientations. In turn, this will aid continued clarity and robust reporting of

qualitative research. To that end we believe it advances knowledge and makes an important

contribution to the field of qualitative inquiry. Thus, the wheel represents the flexibility

inherent in qualitative research while – at the same time – indicating its roots in relation to

the five “traditional” approaches.

Travers (2009) observed two striking responses to innovation within the qualitative

research community: from celebration and promotion of ceaseless innovation on one hand, to

20

defence of tradition on the other. We lean more towards innovation and like many other

qualitative researchers we are excited about the multiple means of inquiry at our disposal that

can lead to advancement of knowledge. The QR-LAW is not intended to draw arbitrary, rigid

lines between different approaches; it actually allows them to be changed. As indicated in

Figure 2, the arrows indicate circular movement that encourages conceptual movement

through each layer (approach, focus, sample and so on) with a visual capturing of this

process. Our intention is to develop the diagrammatic form of the QR-LAW into an actual

resource. This will fully realise its dynamic nature.

The Current State of Qualitative Research: Some Reflections

In their review of nursing studies, Richards and colleagues (2014) found a number of

problems with many articles – both qualitative and quantitative. They reported that among the

qualitative articles, methodological description was often poor, misleading or absent, leading

them to conclude that the reporting leaves much to be desired. Specifically they had

difficulties classifying qualitative designs, with examples of undefined terms such as

‘exploratory comparative design’. Caelli et al. (2003) refer to the state of play in qualitative

research as ‘clear as mud’ and more recently, Lau and Traulsen (2016) have argued that there

are shortcomings in contemporary qualitative health research that need to be addressed. Our

review has also highlighted some problem areas, including an array of terminology being

used, which we agree is very confusing. We accept that there are important lessons regarding

quality of reporting and the QR-LAW may assist this in the ways we have already described.

However, findings from our review do not concur entirely with the view that qualitative

research is in a poor state. In fact, when it comes to level of alignment, we conclude that

qualitative research in the field of health and social science is currently in good shape.

Conclusions

This focused mapping review and synthesis aimed to profile the relationship between

21

qualitative researchers’ philosophical claims and their reported practices in the context of

health and social science journals. We found the targeted nature of the review invaluable in

achieving detailed data mining and from this we were able to build a rich, comprehensive

profile.

Conclusions that can be drawn from the review are that it is sometimes difficult to tell

whether or not an article is qualitative. Much could be done to improve this issue and to make

qualitative articles more identifiable and retrievable. In our sampled articles, the level of

alignment was generally high, particularly in ‘generic qualitative’ studies. Wiles et al. (2011)

cautioned against ‘over-claiming’ innovation in qualitative research and similarly, we

recommend that researchers stay simple to avoid muddling orientation and techniques. Of

course these can be carefully blended and the QR-LAW may assist authors’ clarity, critique

and description when this occurs.

As mentioned at the beginning of this article, Creswell (upon whom we have drawn

heavily) changed the titles of his books on qualitative inquiry from ‘traditions’ (2007) to

‘approaches’ (2013), reflecting a changing world of qualitative research and signalling a

respect for past approaches, while encouraging current practices in qualitative research. He

argued that a ‘healthy respect’ exists for variations within each of the five approaches and

‘there is no single way to approach an ethnography, a grounded theory study, and so forth’

(p.4). This concurs closely with the view of Hammersley (2008) in that approaches often co-

exist in a single study. We agree. We hope the QR-LAW contributes to knowledge in the field

and we envisage that it will assist many qualitative researchers and students undertaking

qualitative classes, to look critically at the orientations and techniques and particularly the

alignment between them. This might promote a healthy respect for the six orientations while

facilitating creative ways of combining them and advancing the field of qualitative inquiry in

the health and social sciences.

22

23

References

Baker, S.E. & Edwards, R. (2014) How many qualitative interviews is enough? Expert voices

and early career reflections on sampling and cases in qualitative research. National

Centre for Research Methods. Available online: http://eprints.ncrm.ac.uk/2273/

Accessed 15/3/2016.

Barbour, R. (2001) Checklists for improving rigour in qualitative research: a case of the tail

wagging the dog? BMJ, 322,1115-7.

Baxter, P. & Jack, S. (2008) Qualitative Case Study Methodology: Study Design and

Implementation for Novice Researchers. The Qualitative Report, 13 (4), 544-559.

Author 1 (2009) details withheld for peer review

Author 2 (2014) details withheld for peer review

Braun, V. & Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research

in Psychology, 3 (2), 77-101.

Breckenridge, J, Jones, D, Elliott, I. & Nicol, M. (2012) Choosing a methodological path:

reflections on the constructivist turn. The Grounded Theory Review 11  (1), 64-71.

Burnard, P. (2004) Writing a qualitative research report. Accident and Emergency Nursing,

12, 176-181.

Caddick, N., Smith, B. & Phoenix, C. (2015) The effects of surfing and the natural

environment on the well-being of combat veterans. Qualitative Health Research,

25(1), 76-86.

Caelli, K., Ray, L. & Mill, J. (2003) ‘Clear as mud’: Toward greater clarity in generic

qualitative research. International Journal of Social Research Methodology, 2(2)

Article 1. Retrieved 26/2/2016 from

https://www.ualberta.ca/~iiqm/backissues/2_2/pdf/caellietal.pdf

Chang, L. & Basnyat, I. (2015) Negotiating biomedical and traditional Chinese medicine

24

treatments among elderly Chinese Singaporean women. Qualitative Health Research,

25(2), 241-252.

Cohen, N.Z. & Omery, A. (1994) Schools of phenomenology: implications for research. In:

Morse J.M. (Ed.) Critical Issues in Qualitative Research Methods. Thousand Oaks,

Sage Publications, 136-156.

Creswell, J.W. (2007) Qualitative Inquiry and Research Design: Choosing Among Five

Approaches (2nd Edition). Thousand Oaks, Sage.

Creswell, J.W. (2013) Qualitative Inquiry and Research Design: Choosing Among Five

Approaches (3rd Edition). Thousand Oaks, Sage.

Critical Appraisal Skills Programme (2013) 10 Questions to Help you Make Sense of

Qualitative Research. Available:

http://media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf

Cutcliffe, J.R. (2005) Adapt or adopt: developing and transgressing the methodological

boundaries of grounded theory Journal of Advanced Nursing 51(4), 421–428.

Davies, C.A. (1999) Reflexive Ethnography; a guide to researching self and others. London,

Routledge.

Druetz, T., Kadio, K., Haddad, S. & Kouanda, S. (2015) Do community health workers

perceive mechanisms associated with the success of community case management in

malaria? A qualitative study from Burkina Faso. Social Science & Medicine, (124),

232-240.

Earle, V. (2010) Phenomenology as research method or substantive metaphysics? An

overview of phenomenology's uses in nursing. Nursing Philosophy, 11(4), 286-296.

Ellen, R.F. (1984) Ethnographic Research: A Guide to General Conduct. London, Academic

Press.

Ellis, C. (2004) The ethnographic I: A methodological novel about ethnography. California,

25

Altimira Press.

Emerson, R.M.N, Fretz, R.I. & Shaw L.L. (2005) Writing ethnographic fieldnotes. Chicago &

London, University of Chicago Press.

Finlay, L. (2012) Debating phenomenological research methods, In: N.Friesen, T.Saevi &

C.Henriksson (Eds.) Hermeneneutic Phenomenology in Education: Method and

Practice, Rotterdam, Sense Publishers.

Fisher, J.A. (2015) Stopped hearts, amputated toes and NASA: Contemporary legends among

healthy volunteers in US phase 1 clinical trials. Sociology of Health & Illness, 37(1),

127-142.

Frost, N., Nolas, S.M., Brooks-Gordon, B., Esin, C., Holt, A., Mehdizadeh, L. &

Shinebourne. P. (2010) Pluralism in qualitative research: The impact of different

researchers and qualitative approaches on the analysis of qualitative data. Qualitative

Research, 10(4), 441-460.

Grant, M. J. & Booth, A. (2009) A typology of reviews: an analysis of 14 review types and

associated methodologies. Health Information & Libraries Journal, 26, 91–108.

Grbich, C. (2007) Qualitative Data Analysis: An Introduction. London, Sage.

Greckhamer, T. & Koro‐Ljungberg, M. (2005) The erosion of a method: examples from

grounded theory. International Journal of Qualitative Studies in Education, 18,6, 729-

750.

Greenhalgh, T., Annandale, E., Ashcroft, R., Barlow, J., Black, N., Bleakley, A. et al. (2016)

An open letter to The BMJ editors on qualitative research. British Medical

Journal, 352: i563.

Guetterman, T.C. (2015) Descriptions of sampling practices within five approaches to

qualitative research in education and the health sciences. Forum Qualitative

Sozialforschung/Forum: Qualitative Social Research, 16(2), http://www.qualitative-

26

research.net/index.php/fqs/article/view/2290/3826

Hammersley, M. (2008) The issue of quality in qualitative research. In Questioning

Qualitative Inquiry: Critical Essays (M. Hammersley, Ed.) Los Angeles, Sage, PP.

158–79.

van Hoof, W, Pennings, G. & de Sutter, P. (2015) Cross-border reproductive care for law

evasion: A qualitative study into the experiences and moral perspectives of French

women who go to Belgium for treatment with donor sperm. Social Science &

Medicine, (124), 391-397.

Hesse-Biber, S. (2010) Qualitative Approaches to Mixed Methods Practice, Qualitative

Inquiry, 16(6), 455-468.

Hesse-Biber, S., Rodriguez, D & Frost, N.A. (2015) Qualitatively Driven Mixed Methods

Research. In: Johnson, B. & Hesse-Biber, S. (Eds.) The Handbook of Mixed and

Multi-method Research, Oxford University Press.

Holton, J.A. (2007) The coding process and its challenges. In: Bryan A, Charmaz K. (Eds)

The Sage Handbook of Grounded Theory. London, Sage, pp.265-290.

Kaplan, A. (1964) The Conduct of Inquiry: Methodology for Behavioural Science. San

Francisco, Chandler.

Kelly, B.C., Trimarco, J., LeClair, A., Pawson, M., Parsons, J.T. & Golub, S.A. (2015)

Symbolic boundaries, subcultural capital and prescription drug misuse across youth

cultures. Sociology of Health & Illness, 37(3), 325-339.

Kitto, S., Chesters, J. & Grbich, C. (2008) Quality in qualitative research: criteria for authors

and assessors in the submission and assessment of qualitative research articles for the

Medical Journal of Australia. Medical Journal of Australia, 188(4), 243–246.

Lau, S.F. & Traulsen, J.M. (2016) Are we ready to accept the challenge? Addressing the

shortcomings of contemporary qualitative health research. Research in Social &

27

Administrative Pharmacy, 1-10. DOI:

http://dx.doi.org/10.1016/j.sapharm.2016.02.014

Liamputtong, P. & Suwankhong, D. (2015) Therapeutic landscapes and living with breast

cancer: The lived experiences of Thai women. Social Science & Medicine, 128, 263-

271.

Madill, A. & Gough, B. (2008) Qualitative Research and Its Place in Psychological Science.

Psychological Methods, 13(3), 254-271.

Manias, E. & Street, A.F. (2000) Rethinking ethnography: reconstructing nursing

relationships. Journal of Advanced Nursing, 33(2), 234-242.

Mannay, D. & Morgan, M. (2015) Doing ethnography or applying a qualitative technique?

Reflections from the ‘waiting field’. Qualitative Research, 15(2), 166-182.

Maxwell, J.A. (2010) Using numbers in qualitative research. Qualitative Inquiry, 16(6), 475-

482.

Meyrick, J. (2006) What is good qualitative research? Journal of Health Psychology, 11(5),

799-808.

Mogensen, L. & Mason, J. (2015) The meaning of a label for teenagers negotiating identity:

experiences with autism spectrum disorder. Sociology of Health & Illness, 37(2), 255-

269.

Norlyk, A. & Harder, I. (2010) What Makes a Phenomenological Study Phenomenological?

An Analysis of Peer-Reviewed Empirical Nursing Studies. Qualitative Health

Research, 20(3) 420–431.

Platt, J. (2016) Using journal articles to measure the level of quantification in national soci-

ologies. International Journal of Social Research Methodology, 19(1), 31-49.

Pope, C. (2005) Conducting ethnography in medical settings. Medical Education, 39(12),

1180–1187.

28

Porter, S. (2008) Nursing research and the cults of phenomenology. Journal of Research in

Nursing, 13(4), 267-268.

Rees, C.E., Monrouxe, L.V., McDonald, L.A. (2015) ‘My mentor kicked a dying woman’s

bed…’ Analysing UK nursing students’ ‘most memorable’ professionalism dilemmas.

Journal of Advanced Nursing, 71(1), 169-180.

Richards, D.A. Coulthard, V. & Borglin, G. (2014) The state of European Nursing Research:

Dead, alive, or Chronically diseased? A systematic literature review. Worldviews on

Evidenced-Based Nursing, 11(3), 147-155.

Riera, A., Ocasio, A., Tiyyagura, G., Krumeich, L., Ragins, K., Thomas, A., Trevino, S. &

Vaca, F.E. (2015) Latino caregiver experiences with asthma health communication.

Qualitative Health Research, 25(1), 16-26.

Riessman, C.K & Quinney, L. (2005) Narrative in Social Work: A Critical Review.

Qualitative Social Work, 4(4), 391-412 doi: 10.1177/1473325005058643.

Ritchie, J. & Spencer, L. (1994) Qualitative data analysis for applied policy research. In:

Bryman. A. & Burgess, R.G. (Eds.) Analysing Qualitative Data. London, Routledge,

p.p. 173-194.

Ritchie, J. & Lewis, J. (2003) (Eds.) Qualitative Research Practice: A Guide for Social

Science Students and Researchers. London, Sage.

Sandelowski, M. (1993) Rigor or rigor mortis: The problem of rigor in qualitative research

revisited. Advances in Nursing Science, 16(2), 1-8.

Sandelowski, M. & Barroso, J. (2007) Handbook for synthesizing qualitative research. New

York, Springer Publishing Company.  

Sandelowski, M. (2015) A matter of taste: Evaluating the quality of qualitative research.

Nursing Inquiry, 22, 86–94.

Savage, M. & Burrows. R. (2007) The coming crisis of empirical sociology. Sociology, 41(5),

29

885–899.

Schwandt, T.A. (2001) Dictionary of qualitative inquiry (2nd Edition). Thousand Oaks, Sage.

Sharma, S., Reimer-Kirkham, S. & Cochrane, M. (2009) Practicing the Awareness of

Embodiment in Qualitative Health Research: Methodological Reflections. Qualitative

Health Research, 19(11), 1642-1650.

Simera, I., Moher, D., Hirst, A., Hoey, J., Schulz, K.F. & Altman, D.G. (2010) Transparent

and accurate reporting increases reliability, utility, and impact of your research:

reporting guidelines and the EQUATOR Network. BMC Medicine, 8,24.

Taber, N. (2010) Institutional ethnography, autoethnography, and narrative: an argument for

incorporating multiple methodologies. Qualitative Research, 10(1), 5-25.

Thomas, S.P. (2005) Through the lens of Merleau-Ponty: advancing the phenomenological

approach to nursing research. Nursing Philosophy, 6(1), 63-76.

Tight, M. (2016) Phenomenography: the development and application of an innovative

research design in higher education research. International Journal of Social

Research Methodology, 19(3), 319-338.

Tong, A., Sainsbury, P. & Craig, J. (2007) Consolidated criteria for reporting qualitative

research (COREQ): a 32-item checklist for interviews and focus groups. International

Journal for Quality in Health Care, (19)6, 349-357.

Travers, M. (2009) New methods, old problems: A sceptical view of innovation in qualitative

research, Qualitative Research, 9(2), 161-179.

Van Mannan, J. (1988) Tales of the Field. Chicago & London. University of Chicago Press.

Walting, C.J. & Linigard, L. (2012) Grounded theory in medical education research: AMEE

Guide No. 70. Medical Teacher, 34(10), 850-861.

Wiles, R., Crow, G. & Pain, H. (2011) Innovation in qualitative research methods: A narrative

review. Qualitative Research, 11(5), 587-604.

30

Table 1: Five main qualitative approaches (adapted from Creswell 2007 & 2013)

Narrative Phenomenology Grounded theory Ethnography Case study

Exploring the life of an individual Understanding the essence of

experiences of a phenomenon

Developing a theory grounded in

data from the field

Describing and interpreting a

cultural/social group

Developing an in depth analysis of a single

case or multiple cases

Data collection Data analysis Data collection Data analysis Data collection Data analysis Data collection Data analysis Data collection Data analysis

Documents and

archival material;

Open ended

interviews;

Participant

observation.

Identify stories;

Locate

epiphanies;

Develop patterns

and meanings.

Long interviews

with small

groups of people

(up to 10).

List statements of

meaning for

individuals;

Group statements

into meaning

units;

Develop textural

and structural

descriptions;

Develop an

overall description

of the experience

(the essence).

Interviews with

around 20-30

people.

Axial coding;

Open coding;

Selective

coding;

Develop a

conditional

matrix.

Participant

observations;

interviews;

artefacts;

documents (through

extended time in

the field).

Analyse data for

themes and

patterns;

Interpret and

make sense of

findings.

Documents;

records;

interviews;

observation;

artefacts.

Establish patterns of

categories;

Direct interpretation;

Develop naturalistic

generalisations.

31

Table 2: Inclusion and exclusion criteria

Inclusion criteria Exclusion criteria

Primary empirical study Systematic reviews

Qualitative research Mixed method studies

Published between 1st January & 31st March 2015 Methodological & theoretical articles

32

Table 3: Mapping proforma for each journal

Journal name: Reviewers’ initials:

Publication details Orientation Techniques Patterning

Issue,

Volume

Author

s

Title of article Stated qualitative

approach in title?

Claimed methodological or philosophical

approach

Data generation Data analysis

approach

Level of alignment between orientation and

technique

Y N Implied

Descriptors:

Stated qualitative approach:

1) One of the five approaches of qualitative inquiry: narrative, phenomenology, grounded theory, ethnography and case study

2) A generic qualitative study (no explicitly stated positioning regarding the five main approaches)

Level of alignment:

An assessment of the alignment between orientation and technique. Do authors do what they say? Ask yourself ‘are there any surprises?’

Have researchers used congruent techniques associated with their claimed approach (phenomenology, grounded theory etcetera)?

33

Table 4: Included articles and analysis of titles

Journal Number of articles meeting inclusion criteria Descriptions of qualitative approach in title

No Implied Yes

BJSW 8 6 2 0

HSCC 13 3 6 4

JAN 13 5 4 4

QHR 29 15 12 2

SH&I 20 6 12 2

SS&M 19 4 10 5

Total 102 39 46 17

34

Table 5: Overview of (adapted) author guidelines for the reporting of original (qualitative) research

Title Data generation techniques Methodology/ Study Design Sampling strategy Data analysis Maximum wordageBJSW Include article title in final

version of manuscriptNot mentioned. Not mentioned. Not mentioned. Not mentioned. Major articles should not

exceed 7000 words in length, excluding the abstract, but including references, tables and figures.

HSCC The title page should contain a concise title of the article.

Include details such as the interviews (or observation approaches or other data collection methods) with rationale and literature support.Data collection procedures including recruitment, settings, sampling, etc.

Include the type of study design including the rationale for the selection of the particular design with literature support.

Include data collection procedures including recruitment, settings, sampling, etc.

Include analysis procedures with literature support. Include details on any computer software used to manage data.

Articles should not exceed 5000 words (excluding figures, tables and the reference list).

JAN Full title (maximum 25 words) Describe each technique used to collect data, such as interview guide questions, or observation checklist items.

State a research question appropriate for the methodology. Describe research design, e.g. grounded theory, phenomenology, ethnography.

Identify the specific purposeful sampling strategy/strategies used-theoretical, maximum variation, extreme case.

Describe the techniques used to analyse the data incl. computer software used.

5000 words for main text.

QHR Supply a title, short title and keywords to accompany your article. Ensure the main key phrase for your topic is in your article title. Make sure your title is descriptive, unambiguous, accurate and reads well.

Not mentioned. Not mentioned. Not mentioned. Not mentioned. Not mentioned.

SHI Not mentioned. Not mentioned. Researchers should strive to describe their methods clearly and unambiguously so that their findings can be confirmed by others.

The criteria for selecting the sample should be clearly described and justified.

Not mentioned. 8000 words in length including notes and bibliography.

SS&M Concise and informative. Avoid abbreviations and formulae where possible and make clear the article’s aim and health relevance.

Provide full details of the research methods used, including study location, sampling procedures, the dates when data were collected, research instruments, and techniques of data analysis.

In the abstract: Country of the study should be clearly stated, as should the methods and nature of the sample, the dates and a summary of the findings/conclusions.

The selection of units of research (e.g. people, institutions, etc.) should be theoretically justified e.g. it should be made clear how respondents were selected.

Include a dedicated methods section which specifies, as appropriate, the sample recruitment strategy, sample size, and analytical strategy.The process of analysis should be made as transparent as possible (notwithstanding the conceptual and theoretical creativity that typically characterises qualitative research).

8000 words including abstract, tables, and references as well as the main text.

35

Table 6: Orientation across journals

Narrative Phenomenology Grounded Theory Ethnography Case Study Generic Qualitative Other

BJSW 0 2 1 1 1 4 0

HSCC 0 0 1 1 1 9 1

JAN 1 1 1 0 0 9 1

QHR 4 5 2 3 1 5 7

SH&I 1 1 2 6 2 7 2

SS&M 0 1 0 5 2 9 2

Total 6(5.9%) 10(9.8%) 7(6.9%) 16(15.7%) 7 (6.9%) 43 (42.1%) 13(12.7%)

36

Table 7: Patterning of alignment and orientation

Narrative Phenomenology Grounded Theory Ethnography Case Study Generic Qualitative Other Total

Low 0 1 1 2 0 0 0 4

Partial 2 2 1 6 3 11 8 33

High 4 7 5 8 4 32 5 65

37

Figure 1: Data generation and analysis techniques

38

Data Generation TechniquesIndividual interviews (87)Observation (14)Focus group interviews (13)Field notes (4)Narrative interviews (1)Other techniques (13)

Data Analysis TechniquesOpen and axial coding, constant comparison, memoing (30)Framework analysis (9)Coding (7)Content analysis (6)Discourse/text analysis (4)Step-wise approach (3)Narrative (3)Bracketing process, hermeneutical phenomenological analysis (2)Other techniques (10)

Figure 2: Qualitative Research Level of Alignment Wheel™ (QR-LAW)

39